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Hope & Prayer in the ICU
By Jeff Unger, MD

Yesterday, Carolyn Roller’s life was being prolonged by a thin thread of spirituality linking her heart and soul with that of her only child, Lisa. With hope seeming to fade by the minute, Lisa went outside the UCLA Medical Center to ask G-d not to “save her Mom’s life,” but to give her a chance to say goodbye. That is, my wife, Lisa, was asking for some additional time she could spend with her Mom, who she knew had a fatal disease.

Unfortunately, Carolyn was in the Intensive Care Unit, being monitored continuously by five nurses and two physicians who were so busy trying to stabilize her that a visit to her bedside was not a practical option.

Feeling Lisa’s emotional pain, I called Rabbi Mendy Harlig in Las Vegas and Rabbi Shalom Harlig in Rancho Cucamonga. Both men immediately provided the spiritual and practical support we required so urgently. I asked them to please send one of the local Chabad rabbis as quickly as possible so that we could all pray for Carolyn. The events that followed opened the eyes of everyone who devoted their lives to the art of healing, and were profoundly moving for those of us who love Carolyn so dearly.

You see, there are truly some things in medicine that go unexplained, things which cannot be addressed in a medical textbook or by asking a colleague for advice. When we as physicians are truly staring death in the eye and death is staring right back at us, who is more likely to win this battle? This is not a battle of good and evil. We all know that death is part of life. What we don’t know is when G-d determines to call each of us to his side. Until that moment comes, we must protect our bodies from harm and allow this G-d given gift to live on.

Carolyn was bleeding profusely. The more blood products she received, the more she bled. Her vital signs were unstable. She had become so acidotic that she was placed on dialysis. Her temperature was dropping. They had taken her to the operating room in the middle of the night and found that her internal bleeding had been so profound that they could only pack the abdomen with dry sponges, leave the skin unsutured, and hope to return her to surgery later -- assuming the bleeding stopped. Carolyn was placed on a ventilator because the bleeding had created a compartment syndrome in which the pressure of the blood within the abdomen prevented the lungs from expanding. Her only chance of survival was a risky procedure in which the radiologist would insert a catheter into an artery and attempt to locate a single arterial vessel which could be the primary source of the bleeding. If such an artery could be identified, a small coil of cotton could be floated into the artery to stop the bleeding, a process known as emobolization. But if the bleeding was not isolated to a single vessel, she would surely die within hours. What made this procedure even more risky was Carolyn’s dangerously low blood acid level. In fact, her blood pH was 6.9, which is essentially incompatible with life. Organ systems cannot function at this level of acidity.

As Lisa and I pondered funeral arrangements for her mother, Rabbi Baitelman appeared “from the East.” He’d been sent by our other rabbis to help comfort us during this emotional time. Rabbi Baitelman had never met us, yet he knew that we were Jewish, and that was all he had to know. He listened for a few moments as I explained the circumstances of Carolyn’s illness. Although I expressed doubt that she would survive, he was very optimistic. He said that we were approaching Shabbat, which was a very special time of the week, a time for which G-d saves many of his joyous and most important events. He pointed out that Shabbat is so special that we do not even wear Tefillin, and then guided me in putting on my own Tefillin before saying the Shema with us. Together we said the Psalm that is traditionally said in honor of those who are ill. The rabbi provided Lisa with some Shabbat candles and explained how, and when, to light them. He also invited us to services that evening.

My wife and I were very comforted by the rabbi’s visit. We knew he would be praying for us, and that we could find him at any time if necessary.

Immediately after the rabbi left our side, the head trauma surgeon flagged us down and told us the first good news we had heard all day: “We were able to locate the single site of bleeding and embolize the vessel. Though we’re not out of the woods yet, this is certainly a positive step. Her condition could still worsen, but now she has a chance!”

Lisa appeared to be getting her prayer answered. She wanted time to be with her mother and, if nothing else, just an opportunity to hold her hand one more time to tell her goodbye. I believe that this was certainly divine intervention, perhaps the result of the Tefillin. Maybe G-d was simply putting on a display of his awesome powers. As I looked outside, the sun had set. Shabbat had begun!

At that very moment, terror struck our hearts as we heard: “Code Blue BCU. Code Blue BCU.” Lisa thought it could be her mother. We ran down to her unit to investigate. As Lisa waited outside, I ran in towards the nursing station. I knew not to go into the unit, but noticed about twenty nurses, doctors, and staffers circling around Carolyn’s bed. Yes, she was the one who was dying. I was told by the unit secretary to leave immediately because they were conducting a “procedure.” I explained that I was fully aware of the “nature of their procedure.” I only asked if Lisa could enter the room to say “goodbye” to her Mom if death appeared imminent.

Suddenly, I heard one of the nurses yell, “Get the chaplain!” Despite the commotion in the unit, I believe everyone heard my response from outside that she had a rabbi. Within ten seconds, her heart began to beat spontaneously once again. Not that the chaplain would have killed her, but she had a gift that perhaps a chaplain couldn’t comprehend. The entire Jewish faith was with her. Yes, Carolyn was actually struggling with the Devil and she beat him once again. Shabbat, Tefillin, rabbis, Judaism, family and faith will beat the Devil out every time. You can take that to the bank!Once Carolyn was stabilized, Lisa and I walked over to the Chabad House for Shabbat services. Rabbi Baitelman noted that we had a Minyan, and as a group we recited the same Psalm for Carolyn. He gave Lisa a small prayer book to place under her mother’s pillow and suggested I say the Shema before leaving that night. He assured us that she would be safe. Rabbi Baitelman offered us a place to stay at Chabad, but we had to pick up our daughter, Chelsea, who was 15 minutes away at a recording studio.

I do believe that these prayers at Chabad helped. We were informed shortly after the services ended that her bleeding had stopped, her temperature had risen, her acid level was normalizing, and her heart rate was stable. Everyone who was caring for her said that they had never seen anything quite like this before. When Carolyn coded earlier that day, her pH was 6.9; I have personally never seen or heard of anyone surviving that low of a pH. She was now at 7.2! I doubt the rabbi knows much about pH levels in the blood, but fortunately, he knows a great deal about the powers of prayer!

When we returned to Carolyn’s bedside for the final time that night, I placed the prayer book near her head and said the Shema as directed. The nurses promised to protect Carolyn and the prayer book from harm. Lisa had an opportunity to say goodnight to her mother once again. She emphasized how important her Mom was to her and that leaving her would simply be unacceptable. Lisa felt as though her Mom could hear her words, but was not certain.

Roughly 30 minutes after placing the prayer book by Carolyn’s head, we received a call from the Nurse in the ICU. Lisa was nervous when she saw the letters, “ICU” on her cell phone. “She just woke up,” the nurse shouted, to me. “She opened her eyes. I asked her if she knew that her daughter and other family members had been here today and she shook her head yes. This is so exciting for all of us.” Lisa and Chelsea were actually able to talk with Carolyn on the phone as the nurse put the phone by her ear. She was responding appropriately to the voices of her daughter and granddaughter.

Turning around, I saw Lisa and Chelsea hugging each other. From the brink of death came the breath of life. To the rabbis, perhaps these are not unexpected events. But to physicians and nurses, they are true medical miracles. And to family members, these events allow yet another opportunity to live together as one while bearing true witness to the amazing powers of G-d.

Dr. Unger is an assistant professor of family medicine at Loma Linda University School of Medicine. He directs the Chino Medical Group Diabetes and Headache Centers and is the team physician for the Rancho Cucamonga Quakes, an affiliate of the Los Angeles Angels of Anaheim professional baseball team. Dr. Unger is the Editor-in-Chief of several medical journals directed towards primary care physicians.

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